Friction-Related Disease Associated With Meiboian Gland Dysfunction, Dropout Rate

Dry Eye
Aqueous deficiency and tear meniscus height also show a good association with friction-related disease, but to a lesser extent than MGD and meibomian gland dropout rate.

Friction-related disease (FRD) is highly associated with meibomian gland dysfunction (MGD) and meibomian gland dropout rate, according to a study published in The Ocular Surface. Secondary findings revealed that aqueous deficiency (AD) and tear meniscus height (TMH) are also associated with FRD, but to a lesser degree than MGD and meibomian gland dropout rate. 

Investigators conducted a cross-sectional, comparative study of 550 patients with dry eye disease (DED) at a single center from January 2019 to December 2020. They analyzed DED subtype and dynamic tear-film parameters via interferometry and keratography.

Researchers noted that participants with FRD were older compared with those without FRD (mean age, 59.8±18.1 and 54.7±18.2 years, respectively, P =.002) and noted no significant differences in sex distribution among the groups (P =.547). They found that patients with FRD experienced a higher proportion of moderate-to-severe MGD and AD (P <.001 for both).

Investigators also observed that meibomian gland dropout rate was higher, TMH was lower, and the first non-invasive keratographic tear break-up time (NIKBUT-1) was shorter in patients with FRD compared with those without it (30.5±31.8 and 14.1±25.0%, P <.001; 227.8±60.4 and 241.7±55.6 μm, P =.008; 5.9±3.5 and 7.3±3.7 s, P <.001, respectively). Logistic regression analysis showed that moderate-to-severe MGD and AD were associated with FRD (OR: 12.27, 95%, CI, 7.72–19.50, and OR: 2.31, 95% CI, 1.43–3.71), respectively, P <.001 for both). Meibomian gland dropout rate was positively associated with FRD (OR: 1.017, 95% CI, 1.010–1.023, P <.001), while TMH and NIKBUT-1 were negatively associated with FRD (OR: 0.995, 95% CI, 0.991–0.999, P =.039 and OR: 0.90, 95% CI, 0.85–0.95, P <.001, respectively).

The researchers suggest that “FRD may be mainly affected by lipid components,” and encourage further investigations to establish whether “MGD and AD are the causes of FRD, or temporally precede FRD.” 

A limitation of this research is the single center design.


Ahn H, Ji YW, Jun I, Kim T-i, Lee HK, Seo KY. Effects of meibomian gland dysfunction and aqueous deficiency on friction-related disease. The Ocular Surface. Published online February 24, 2022. doi:10.1016/j.jtos.2022.02.002